Changes in Conflict Resolution Style over Time: The Risk for Persons with Alzheimer’s Dementia

Abstract Background: Elder mistreatment is a serious issue affecting between 300,000 and 800,000 older adults. Elder mistreatment has serious consequences for older adults and can include immunological dysfunction, increased mortality and emotional difficulties such as depression, feelings of inadequacy and self-contempt. Sub-groups such as persons with Alzheimer’s disease have heightened risk for elder mistreatment, but it is not clear whether this heightened risk represents life-long patterns of abuse between persons or whether they represent a change in conflict style over time as a result of changes associated with dementia. Methods: Data analyzed in this study were collected as part of the Aggression and Violence in Community Based Alzheimer’s Study [AV-CAD] and represents patient caregiver/dyads who received care at one of five state funded medical clinics or who belonged to one of three local chapters of the Alzheimer’s Association. Data were collected via in-person interview and mailed survey, and changes in conflict resolution style (reasoning, verbal aggression and violence) pre and post dementia were measured using the Conflict Tactic Scale (CTS) and analyzed using McNemar’s Test. Results: Reasoning was used as a conflict resolution style in 91.4% of caregivers and 89.3% of elders prior to the onset of dementia and in 66.3% of caregivers and 45.3% of elders in the past year (post dementia diagnosis). Reasoning in the post dementia period was significantly related to use of reasoning in the pre dementia period for caregivers (X2=7.47, p=.0032) and approached significance for elders (X2=6.00; p=.057). Use of verbal aggression (VA) and violence (V) as a conflict resolution style post dementia was higher for both caregivers (VA: 59.3%; V: 16.8%) and elders (VA: 68.7%; V: 24%), but was not significantly related to behaviors in the pre-dementia period for caregivers (V: X2=1.55, p=.536; VA: X2=0.67, p=.528) or elders (V: X2=0.54, p=.628; VA: X2=0.43, p=.621). Conclusions: This study lends support to the idea that elder abuse in a large number of persons with Alzheimer’s disease may be in part a result of the etiology of the disease and is susceptible over time. Implications for policy, practice and future research are discussed

Physical Mistreatment in Persons with Alzheimer’s Disease

Physical mistreatment has been estimated to affect 2 million older persons each year and dramatically affects health outcomes. While researchers have attempted to examine risk factors for specific forms of abuse, many have been able to focus on only victim or perpetrator characteristics, or a limited number of psychosocial variables at any one time. Additionally, data on risk factors for subgroups such as persons with Alzheimer’s disease who may have heightened and/or unique risk profiles has also been limited. This paper examines risk for physical violence in caregiver/patient dyads who participated in the Aggression and Violence in Community-Based Alzheimer’s Families Grant. Data were collected via in-person interview and mailed survey and included demographics as well as measures of violence, physical and emotional health, and health behaviors. Logistic regression analysis indicated that caregivers providing care to elders with high levels of functional impairment or dementia symptoms, or who had alcohol problems, were more likely to use violence as a conflict resolution strategy, as were caregivers who were providing care to elders who used violence against them. By contrast, caregivers with high self-esteem were less likely to use violence as a conflict resolution strategy. Significant interaction effects were also noted

Experimental measurements of high-energy photons in X-rays pulses emitted from a hundred joules plasma focus device and its interpretations

In the present work, efforts are made to identify the presence of high energy photons in X-rays pulses, emitted from a hundred joules plasma focus device, PF-400J. Two different experiments were carried out, with the insertion of a lead piece inside the hollow anode of PF-400J and without insertion of the lead piece. A pair of two photomultiplier tubes (PMTs) was mounted in the axial direction and a similar pair of PMTs was mounted in the radial direction, simultaneously. After establishing a correlation between two PMTs in each pair, one of the PMTs in both directions was blocked by a rectangular slab of the lead of thickness ~17 mm. Linear attenuation coefficient (LAC) of lead was estimated using the PMTs signals. Later, the X-rays energies were interpolated for the estimated LAC values in both cases, with and without insertion of lead piece inside the hollow anode. Interpolated energies reveal the presence of 0.55–0.85 MeV photons in the X-rays pulses in the axial direction, while, in radial direction ranges 0.4–0.9 MeV, for the case without lead inserted inside the hollow anode. Insertion of the lead inside the hollow anode does not change the X-rays energies significantly, nonetheless, it increases X-rays repetition rate per hundred discharges. The presence of high energy photons in the X-rays pulses indicates the existence of relativistic electrons. To explain it, induced electric and magnetic fields were estimated using generalized Ohm’s law. We conclude that the electron acceleration mechanisms might not be the same in the axial and radial directions.Indexación: Scopu

Risk factors for recurrent injurious falls that require hospitalization for older adults with dementia: a population based study

Background: Older adults with dementia are at an increased risk of falls, however, little is known about risk factors for recurrent injurious falls (a subsequent fall after the first fall has occurred) among this group. This study aimed to identify risk factors for recurrent injurious falls requiring hospitalization among adults aged 60+ years with dementia. Methods: This retrospective, whole-population cohort study was conducted using the Western Australian Hospital Morbidity Data System and Western Australian Death Registrations from 2001 to 2013. Survival analysis using a stratified conditional Cox model (type 1) was undertaken to identify risk factors for recurrent injurious falls requiring hospitalization. Results: There were 32,519 participants with an index hospital admission with dementia during the study period. Over 27 % (n = 8970) of the cohort experienced a total of 11,073 injurious falls requiring hospitalization during follow up with 7297 individuals experiencing a single fall, 1330 experiencing two falls and 343 experiencing three or more falls. The median follow-up time for each individual was 2.49 years. Females were at a significantly increased risk of 7 % for recurrent injurious falls resulting in hospitalization (adjusted hazard ratio 1.07, 95 % CI 1.01–1.12), compared to males. Increasing age, living in rural areas, and having an injurious fall in the year prior to the index hospital admission with dementia also increased the risk of recurrent injurious falls resulting in hospitalization. Conclusions: Screening those with dementia for injurious falls history could help to identify those most at risk of recurrent injurious falls. Improvement of heath care an

The mental health care context and patient characteristics: Implications for provider job satisfaction

This research examines job satisfaction among 282 staff providing mental health care to 574 patients with serious mental illness. The mental health staff worked in 18 Department of Veterans Affairs inpatient and outpatient mental health care units at 12 Veterans Affairs Medical Centers located across the contiguous 48 states. The purpose was to identify (1) aspects of the health care context that were associated with provider job satisfaction and (2) administrative and organizational procedures/interventions that might sustain or improve provider job satisfaction. The association of provider job satisfaction with patients' functional status and symptom severity was tested in multilevel statistical models that accounted for provider and unit characteristics. Provider job satisfaction was found to be greater on smaller units and units with higher patient functioning and lower illness severity. Implications of these results are discussed.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/45774/1/11414_2005_Article_BF02287373.pd

Cross-sectional and longitudinal risk of physical impairment in a cohort of postmenopausal women who experience physical and verbal abuse

BACKGROUND: Exposure to interpersonal violence, namely verbal and physical abuse, is a highly prevalent threat to women’s health and well-being. Among older, post-menopausal women, several researchers have characterized a possible bi-directional relationship of abuse exposure and diminished physical functioning. However, studies that prospectively examine the relationship between interpersonal abuse exposure and physical functioning across multiple years of observation are lacking. To address this literature gap, we prospectively evaluate the association between abuse exposure and physical functioning in a large, national cohort of post-menopausal women across 12 years of follow-up observation. METHODS: Multivariable logistic regression was used to measure the adjusted association between experiencing abuse and physical function score at baseline in 154,902 Women’s Health Initiative (WHI) participants. Multilevel modeling, where the trajectories of decline in physical function were modeled as a function of time-varying abuse exposure, was used to evaluate the contribution of abuse to trajectories of physical function scores over time. RESULT: Abuse was prevalent among WHI participants, with 11 % of our study population reporting baseline exposure. Verbal abuse was the most commonly reported abuse type (10 %), followed by combined physical and verbal abuse (1 %), followed by physical abuse in the absence of verbal abuse (0.2 %). Abuse exposure (all types) was associated with diminished physical functioning, with women exposed to combined physical and verbal abuse presenting baseline physical functioning scores consistent with non-abused women 20 years senior. Results did not reveal a differential rate of decline over time in physical functioning based on abuse exposure. CONCLUSIONS: Taken together, our findings suggest a need for increased awareness of the prevalence of abuse exposure among postmenopausal women; they also underscore the importance of clinician’s vigilance in their efforts toward the prevention, early detection and effective intervention with abuse exposure, including verbal abuse exposure, in post-menopausal women. Given our findings related to abuse exposure and women’s diminished physical functioning at WHI baseline, our work illuminates a need for further study, particularly the investigation of this association in younger, pre-menopausal women so that the temporal ordering if this relationship may be better understood

The prevalence of overweight and obesity at Secondary School Pupils in the Region of Klatovsko.

This thesis deals with finding the prevalence of overweight and obesity among children in the second grade of primary school in the region Klatovy. The data analysis was used the height and weight of probands BMI index, also used values of waist circumference and hip circumference, WHR index determination. The research was conducted at seven elementary schools in the region Klatovy and was attended by only 230 children, 110 boys and 120 girls. The observed prevalence of probands is 6,08 % for overweight and 1,73 % for obesity

Design of brushless direct current motor with Halbach array

Předkládaná bakalářská práce je zaměřena na návrh bezkartáčového stejnosměrného motoru využívajícího Halbachovo pole s dvojitým rotorem, společně se statorem vytvořených pomocí 3D tisku. Nejprve je v práci popsáno, jaké existují různé uspořádání BLDC motorů a nadále princip Halbachova pole a jeho využití v průmyslu. Následuje postup a zjednodušený návrh konkrétního BLDC motoru a ověření modelu v simulačním programu ANSYS a stanovení jeho parametrů.ObhájenoThis thesis is focused on design of a brushless direct current motor which use Halbach array of permanent magnets with double rotor and together with stator they are 3D printed. Typical arrengements of BLDC motor are discussed in the first part of this thesis, following by explanation of principle of the Halbach array and it´s use in industry. After that a simplified design of a specific BLDC motor is submitted and simulated in ANSYS programme